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Viscoelastic demonstrates cohesive, dispersive properties from start to finish
This ‘viscous dispersive’ ophthalmic viscosurgical device is optimized for every phase of cataract surgery, one surgeon says.
An ophthalmic viscosurgical device with both cohesive and dispersive properties is well-suited for all phases of cataract surgery, according to a surgeon who uses it routinely.
For the past several months, Satish S. Modi, MD, has been using DisCoVisc (sodium chondroitin sulfate 4%, sodium hyaluronate 1.65%, Alcon) in 100% of his cataract surgery cases, he told Ocular Surgery News.
DisCoVisc was named for its marriage of dispersive and cohesive viscoelastic properties, according to Dr. Modi.
“It is what is called a viscous dispersive,” he said. “Up until this point, there has not been one ideal viscoelastic for the whole procedure because you could not reconcile cohesive and dispersive [properties].”
The dispersive quality of the material allows DisCoVisc to stay in the eye and provide endothelial protection, but it is also sufficiently cohesive to maintain the shape of the anterior chamber and manipulate tissue, he said.
“I was a skeptic that it would protect the endothelium as well as Viscoat [chondroitin sulfate 4%, sodium hyaluronate 3%, Alcon], but studies have shown that it does, and my clinical results have shown it as well,” Dr. Modi said. “DisCoVisc provides superior protection of the corneal endothelium during high flow phaco.”
According to company literature, DisCoVisc combines the advantages of higher-viscosity cohesive ophthalmic viscosurgical devices (OVDs) with those of lower-viscosity dispersive OVDs. DisCoVisc has an intermediate cohesive-dispersive index, the product insert states.
From start to finish
“This is the first viscoelastic optimized for the entire surgical procedure,” he said.
He said he uses DisCoVisc initially to maintain space in the anterior chamber and to protect the endothelium during capsulorrhexis and phacoemulsification. Later, he uses the material to fill the capsular bag for IOL implantation. DisCoVisc behaves appropriately during all these phases of surgery, he said.
“At the beginning of the procedure, you want a cohesive to fill space well for capsulorrhexis,” he said. “If you don’t, the aqueous humor comes out and the iris and lens sit right up against the endothelium, and if you try to introduce an instrument you will scrape the endothelium. In the middle of the procedure, during phaco, I really want a dispersive that will stay in the eye, resist the high flow and protect the endothelium. At the end, I want one that will go in and easily fill the bag and yet allow me to pull it out quickly.”
He said he has found that DisCoVisc performs as needed in all these situations.
Difficult cases
Dr. Modi said he uses a single 1-cc syringe of DisCoVisc during the entire procedure, even in complicated cases.
“If there is a vitrectomy, I am using that same 1 cc of DisCoVisc,” he said.
In small, hyperopic eyes, it is even more critical to maintain space to perform cataract surgery, Dr. Modi said. In these eyes, the material performs as needed.
“DisCoVisc maintains space even in a positive, hyperopic eye,” he said.
Dr. Modi said he has observed few to no pressure spikes after surgery using DisCoVisc.
For Your Information:
- Satish S. Modi, MD, can be reached at 23 Davis Avenue, Poughkeepsie, NY 12603; 914-454-1025; fax: 845-454-5881; e-mail: smodieyes@aol.com.
- Alcon, maker of DisCoVisc, can be reached at 6201 South Freeway, Fort Worth, TX 76134; 817-293-0450; fax: 817-568-6142; Web site: www.alconlabs.com.
- Daniele Cruz is an OSN Staff Writer who covers all aspects of ophthalmology.